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Infertility Aprils, Chapter I, 2011: The Little Embryo That Could

April has traditionally been a pivotal month in our infertility journey. I can’t explain why we have experienced the highest of highs and the lowest of lows during each of our infertility Aprils. If I were a person who believed in numerology or put my faith in numbers as a way to determine my fate, the number four (4) would be the equivalent of an all-stakes roll of the dice in the game of procuring a baby.

April, 2011: I always prefer to start with the happy stuff first, don’t you? This month four years ago marked our first IVF cycle, and resulted in the birth of the joy of our lives, E, in December 2011. The truth is, many people don’t know how close he came to not existing at all. Even more truthfully, John and I didn’t learn until over three years later that statistically he should not be here, and the only reason he is, is because he was a particularly tenacious little embryo.

One week before my scheduled egg retrieval in mid-April, our RE (reproductive endocrinologist) looked sadly at me after looking mournfully at the ultrasound screen. Sad and mournful are not looks we wanted to see from the doctor who we considered the guardian of our hopes, dreams, and $25,000. Despite tacking on an extra week to my protocol and subjecting my body to even harsher hormones to get optimal results,the $3500 worth of drugs they had me jabbing into myself twice a day had only resulted in the development of five mature eggs. Hence her sad and mournful countenance.

The process of IVF is to stimulate the ovaries so greatly that a woman has 15-25 eggs ready to harvest by retrieval time. The RE recommended to the hubs and I that we convert this IVF cycle to an IUI cycle, and try IVF again in a couple months. In other words, she could shoot some of the hubs’ swimmers into my uterus like a sling shot and we could all pretend that maybe it worked for a couple weeks. No matter that it had been definitively decided months before, by our RE, that IUI (inter uterine insemination) would never work for us, and that the other fertility clinics were staffed by imbeciles who didn’t read our lab work properly and put us through three meaningless rounds of IUI. So said this very doctor who was now suggesting doing the same flipping thing(one of the many hundreds of reasons infertility can break you down—at times, you realize your doctor isn’t even paying attention, and it sucks.)

First off, five eggs chilling in my ovaries may not sound like much, but if a quirky little miracle occurred and some of them managed to be fertilized, this is how one finds themselves pregnant with a litter. Stories of quads, quints, sextuplets, etc. are almost always the result of an IUI. Many people believe IVFs are responsible, but it is a much more rigorously controlled procedure that is designed to result in the birth of just one baby. There are only two exceptions to this I can recall offhand, one being the Octomom, who found a shady fertility specialist that would transfer eight fertilized embryos into her womb at once. That is a giant no-no. The industry standard is to transfer two embryos max into women under the age of 41 with a history of fertility problems; recently, it has been changing to where many clinics really only want to transfer one embryo, in order to eliminate the possibility of multiples. It is considered acceptable to transfer a maximum of three embryos into a women aged 41 and older, simply because the odds of success with IVF go down incrementally after age 35, and then take a gigantic nosedive at age 41. The other IVF example in the news recently is the story of the Gardner quadruplets. The mother had two fertilized embryos transferred, perfectly ethical, and in a nearly unheard of twist, both embryos split and resulted in the birth of two sets of identical twin girls. Other than that, the finger should be pointed squarely at IUI regarding high order multiples.

As I said, I wasn’t too keen on the idea of the hub’s sperm having free reign in my uterus with five of my eggs bouncing around in there. So far none of our genetic material had demonstrated a lot of motivation, but you never knew when those guys might wake up and decide, “Hey, we should really stop being lazy and do something with our lives.” I didn’t want those sperm turning over a new leaf and living it up, like it was Spring Break for frat boys in my womb.

Also, I had just put myself through countless shots, sleepless nights, scary mood swings, a ten pound weight gain, and in the name of 8lb 6oz Baby Jesus I was going to do this IVF come hell or high water. I told the doctor we were continuing with the IVF and that was that. She sort of sighed, but respected my decision, and scheduled our egg retrieval for exactly one week later.

There are a lot of people out there who believe IVF is a godless way to have a baby. Oh how I despise those people. You can always tell who they are, too. They reek of “Church Lady” from the old days of Saturday Night Live, portrayed by Dana Carvey. With a bit of an open mind, they would see how God’s work is embedded everywhere throughout the IVF process. Like when the RE went to retrieve my eggs seven days later, and she not only extracted the five healthy follicles she had seen on the ultrasound the week before, but also retrieved an additional five that had previously not been seen on ultrasound. They had appeared and grown rapidly in the span of one week, something that is supposed to be impossible. At the end of the retrieval, we had ten healthy, mature eggs. The next day, we had ten fertilized embryos. Five days after that, we had two fresh blastocysts to transfer and five to freeze. The remaining three didn’t survive the freezing process, but overall the results were excellent. Six days after the egg retrieval, we had the fresh embryo transfer. And ten days later, my pregnancy was confirmed. That was a banner April, the gold standard of all the months in all the years, in our quest to build a family.

Last summer, an especially intrepid fertility specialist was looking at our old lab work from spring 2011, trying to see if it would provide him with any clues as to why we had experienced three failures in a row as we tried for number two. He called me to say that with the numbers he was looking at, the odds of a successful pregnancy in April of 2011 had been about 10%. Ezra truly was a tenacious little soul who fought his way here, and we should count our lucky stars that he did. The bad news of course, was that fertility labs don’t improve with time, they worsen. If our odds were 10% at age 32 in April 2011, they were exponentially worse at age 35 in June 2014. Oddly, instead of feeling despair, I felt overwhelmingly grateful that my little creature decided to buck the statistics and show up anyway. Even then, I knew we would find other ways to grow our family, and I felt very peaceful and hopeful about what was in store down the road.

Tomorrow I will share the exciting tale of how two teeny tiny little feline creatures rescued me from falling into despair, courtesy of the dreaded April of 2014.

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In the midst of winter, I found there was, within me, an invincible summer. No matter how hard the world pushes against me, within me there's something stronger--something better, pushing right back. -Albert Camus